BACKGROUND Hip fracture is a major health concern with high rates of mortality and disability. The purpose of this study was to conduct a systematic review and meta-analysis on the incidence of hip fracture in the Eastern Mediterranean Region (EMR). METHODS We searched the databases of PubMed, Scopus, Web of Science and Index Medicus for the EMR for observational studies reporting the incidence of fracture in the EMR countries, which were published from inception to September 2018 with no language restriction. Study selection and data extraction were conducted independently by two reviewers. RESULTS After applying inclusion and exclusion criteria, 10 articles were finally included in this study. The overall pooled crude incidence rate of hip fracture in the EMR was estimated to be 107.4 per 100,000 population/year (95% confidence interval [CI]: 83-131.8). Analysis also showed that the overall pooled age-standardized rate was 174.4 per 100,000 population/year (95% CI: 103.9-244.9). Lebanon had the highest crude incidence rate (140.1 per 100,000 population/year), and Kuwait had the lowest rate (21.9 per 100,000 population/year). Age-standardized rate for males was 121.3 per 100,000/year (95% CI: 80.8-161.7) and for females was 227.4 per 100,000/year (95% CI: 129-325.9). The overall crude incidence for traumatic fracture was estimated to be 79.2 per 100,000/year (95% CI: 21.8-136.6). CONCLUSIONS A considerable incidence rate was seen for hip fractures. There were also significant variations in the incidence of different countries of the EMR. Implementing preventive measures against fractures is needed in the region.